Ceska Gynekologie-Czech Gynaecology最新文献

{"title":"Preoperative and postoperative staging in endometrial cancer - a prospective study.","authors":"Ondřej Brych, Jana Drozenová, Tomáš Pichlík, Martin Hruda, Lukáš Rob, Helena Robová, Petr Waldauf, Polyna Themistocleous, Michael J. Halaška","doi":"10.48095/cccg20245","DOIUrl":"10.48095/cccg20245","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to determine how often changes the stage of the tumour in definitive histology against preoperative clinical stage in patient cohort with diagnosed endometrial cancer.</p><p><strong>Methods: </strong>We evaluated prospectively a cohort of 166 patients with endometrial cancer. They all underwent abdominal hysterectomy, bilateral salpingo-oophorectomy, sentinel lymph node biopsy. Patients with high-risk tumours also pelvic lymfadenectomy. We collected data of preoperative diagnostic biopsy and postoperative definitive histology. The data were statistically processed.</p><p><strong>Results: </strong>Detection of sentinel lymph node was successful in 71.1%, bilateral successful detection was in 40.6%. Discrepancy of tumour grade between preoperative biopsy and definitive histology was generally 31.4%. Upgrading of the tumour was in 22 (14.4%) cases, downgrading in 26 (17%) cases. Upgrade from low-risk to high-risk group of tumours was noticed in eight cases. Histopathological tumour type changed in 6.6%, 4.6% moved to histopathologic high-risk group. The tumour stage changed in definite histology in 57.3%, in 19.2% of cases moved from stage low/intermediate-risk group to intermediate-high/high-risk disease group.</p><p><strong>Conclusion: </strong>Correct assessment of preoperative clinical stage and histological grade of endometrial cancer is burdened with a high inaccuracy rate. A lot of cases is up-staged after surgical staging and moved to intermediate-high/high-risk disease group. Results confirm the importance of oncogynaecologic centre II. evaluation of histopathology findings from diagnostic biopsies made in referring hospitals. Sentinel lymph node biopsy should be performed even in clinically low/intermediate-risk disease group.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"89 1","pages":"5-10"},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of life and psychosexual functioning of infertile women and men based on their specific diagnosis.","authors":"Jana Daňková Kučerová, Kateřina Klapilová, Andrea Rákosová Kagánková, Pavel Otevřel, Jan Štelcl, Milan Kudela, Lenka Martinec Nováková","doi":"10.48095/cccg2024282","DOIUrl":"https://doi.org/10.48095/cccg2024282","url":null,"abstract":"<p><strong>Aim: </strong>The aim of the study was to evaluate the influence of a specific diagnosis of infertile women and men on their life quality and psychosexual functioning based on internationally validated questionnaires.</p><p><strong>Materials and methods: </strong>A total of 853 couples seeking treatment for infertility completed the gender-specific batteries comprised of Fertility Quality of Life tool (FertiQoL), Female Sexual Function Index (FSFI) in women, and Brief Sexual Function Inventory (BSFI) in men. Women were followed in the group of primary and secondary infertility and then with specific diagnoses - polycystic ovary syndrome, tubal factor, endometriosis, and idiopathic sterility. Men's categories reflected spermiogram results, i.e., normozoospermia, merged categories of milder disorders of a spermiogram (teratozoospermia, asthenozoospermia, oligozoospermia, and oligoasthenoteratospermia), oligoasthenoteratospermia (OAT) gravis, azoospermia, and when the man was not examined.</p><p><strong>Results: </strong>When evaluating the quality of life in women, we found statistically significant differences between primary and secondary sterility. Primary infertile women scored worse especially in the social area. Worse assessment appeared also in mind-body (area evaluating affliction of the body). Emotional and relational domains included similar results in primary and secondary infertile women. With a specific diagnosis, statistically significant differences were not proved. Using the orientational cut-off score, FertiQoL stated that approximately 10% of women experienced adverse quality of life in relation to fertility. In the domain of sexual functioning, 30% of women demonstrated clinically significant dysfunctions. In men, respondents in the normozoospermic and non-diagnosed categories scored higher than those in the merged category and OAT gravis. Only 2% of men felt their quality of life was poor due to fertility, and clinically significant dysfunctions appeared only in 3% of them.</p><p><strong>Conclusion: </strong>In women, impaired fertility-related quality of life and psychosexual functioning are significantly linked to primary sterility, where specifically the social domain is affected. The impact of a specific diagnosis appears to be minimal. We found high levels of sexual dysfunctions in women. In men, we follow the link of evaluated quality of life in connection with their results of the spermiogram. With spermiogram defects, both areas of functioning can be affected.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"89 4","pages":"282-292"},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical treatment of recurrent gynecological malignancies.","authors":"Tomáš Crha, Vít Weinberger, Luboš Minář, Michal Felsinger, Markéta Bednaříková, Jitka Hausnerova","doi":"10.48095/cccg2024309","DOIUrl":"https://doi.org/10.48095/cccg2024309","url":null,"abstract":"<p><strong>Objective: </strong>A comprehensive overview of surgical treatment of recurrent gynecological malignancies. Recurrent breast malignancies are not included in this review.</p><p><strong>Methodology: </strong>A review providing overview of surgical treatment options for recurrent malignancies of adnexa of the uterus (ovary, fallopian tube), uterine corpus, uterine cervix, and carcinoma of the vagina and vulva.</p><p><strong>Conclusion: </strong>Optimal surgical treatment for patients with recurrent cancer is based on multidisciplinary approach with stratification according to individual prognostic markers. These include patient's performance status, outcome of primary surgery, current extent of recurrence, and histopathological, molecular, and biochemical characteristics. Decision about choice of treatment should be individually discussed and evaluated by the multidisciplinary oncogynecological commission board.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"89 4","pages":"309-318"},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of delivery mode on epigenetic changes in newborns and their health outcomes.","authors":"Zuzana Turcsányiová, Petra Gašparová, Zuzana Ballová, Erik Dosedla","doi":"10.48095/cccg2024329","DOIUrl":"https://doi.org/10.48095/cccg2024329","url":null,"abstract":"<p><p>Recent decades have seen a notable increase in cesarean section rates. Although lifesaving, cesarean delivery is associated with an elevated risk of adverse health outcomes in newborns, including respiratory diseases, atopic disorders, obesity, diabetes, and severe autoimmune conditions. The exact mechanisms underlying these associations remain elusive; however, epigenetic modifications have emerged as a plausible molecular basis linking perinatal factors with future disease susceptibility. This review summarizes current literature, revealing that the delivery method may influence epigenetic markers in neonates, primarily through alterations in global DNA methylation and gene-specific methylation patterns.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"89 4","pages":"329-334"},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic endometritis - a constantly discussed issue in infertile women.","authors":"Kryštof Břečka, Borek Sehnal, Kateřina Maxová, Michael Jiří Halaška, Kristýna Keprtová, Martin Hruda, Lukáš Rob, Tonko Mardešič","doi":"10.48095/cccg2024230","DOIUrl":"https://doi.org/10.48095/cccg2024230","url":null,"abstract":"<p><strong>Objective: </strong>A review of current knowledge on the pathophysiology, diagnostic and treatment options for chronic endometritis in infertile women.</p><p><strong>Methods and results: </strong>One of the major causes of failed in vitro fertilization (IVF) is undiagnosed intrauterine pathologies, including chronic inflammation of the uterine mucosa - chronic endometritis. However, some authors relativize the negative impact of chronic endometritis on reproductive outcomes. The etiopathogenesis of chronic endometritis is due to qualitative and quantitative changes in the endometrial microbiome with abnormal multiplication of microorganisms naturally occurring in the uterine cavity or vagina. There is no uniform consensus on the most common pathogen causing chronic endometritis. It is characterized by infiltration of plasma cells into the endometrial stroma outside the menstrual cycle, accompanied by hyperaemia and endometrial oedema. Clinical symptoms are very mild or absent. The diagnosis of chronic endometritis is often difficult because there is no specific clinical or laboratory diagnostic method. The following investigative options are commonly used for the diagnosis of chronic endometritis: diagnostic hysteroscopy, histopathological examination of the endometrium including CD 138 immunohistochemistry and culture from the uterine cavity. However, standardised international hysteroscopic and histopathological criteria for accurate diagnosis of chronic endometritis are still lacking. Empirically administered antibiotic therapy improves the success rate of pregnancy and delivery of a viable foetus in infertile patients with proven chronic endometritis. In addition to reviewing the current knowledge of chronic endometritis, this article discusses the importance of hysteroscopy in the diagnostic process.</p><p><strong>Conclusion: </strong>Chronic endometritis is often a clinically silent disease with negative impact on reproduction in infertile women. Although there are still many unresolved issues, the introduction of hysteroscopy into the diagnostic process is important for clinical practice; however, hysteroscopy even in combination with histological examination of the endometrium, often does not allow an unequivocal diagnosis of chronic endometritis. Further prospective randomised studies in a selected group of women with proven chronic endometritis and repeated failure to implant proven euploid embryos should refine this knowledge.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"89 3","pages":"230-236"},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simulation medicine in obstetrics and gynaecology, possibilities for its use and the current state at the obstetrics and gynaecology departments in the Czech Republic.","authors":"Emil Havránek, Matěj Anton, Lukáš Hruban","doi":"10.48095/cccg2024196","DOIUrl":"https://doi.org/10.48095/cccg2024196","url":null,"abstract":"<p><strong>Introduction: </strong>Simulation medicine is no longer just a modern trend and has become a standard part of education and training of the medical staff and students in many countries around the world. Its validity and benefits have been acknowledged and its necessity is reflected in the recommendations of the European Board and College of Obstetrics and Gynaecology.</p><p><strong>Objectives: </strong>The aim of our work was to map the current state of simulation training at large obstetrics and gynaecology departments in the Czech Republic including the equipment available, teaching environment conditions and human resources and to find out to what extent individual teaching methods are being used in undergraduate and postgraduate education.</p><p><strong>Methods: </strong>We have collected the information using a questionnaire which focused on the equipment available to the departments, teaching environment conditions, human resources, and types of simulation methods being used in undergraduate and postgraduate training as well as the spectrum of courses being offered.</p><p><strong>Results and conclusion: </strong>Our finding is that large obstetrics and gynaecology departments in the Czech Republic are well equipped, have good teaching environments available to them, and are able to use most of the current simulation teaching methods. On the other hand, except for an operative vaginal birth course, only a small number of other simulation courses are currently being offered. Data from the survey are further used to discuss the possibilities of developing simulation training in this field in the Czech Republic.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"89 3","pages":"196-202"},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gynecological aspects that may affect the risk of preterm birth and the success of embryo transfers after uterus transplantation.","authors":"Roman Chmel, Marta Nováčková, Zlatko Pastor","doi":"10.48095/cccg2024493","DOIUrl":"https://doi.org/10.48095/cccg2024493","url":null,"abstract":"<p><p>Absolute uterine factor infertility is conditioned by the congenital or acquired absence of the uterus or the presence of a nonfunctioning uterus in women who wish to become biological mothers. Uterine transplantation along with assisted reproductive techniques can provide this option for women without a uterus. In the early research period, to minimize the risk of preterm birth and other pregnancy-related complications, the uterus of a donor with a history of one to three successfully completed pregnancies was recommended for transplantation. We believe that insisting on a singleton pregnancy is necessary to reduce the risk of premature birth in uterus recipients, rather than insisting on donating a uterus from a woman with a history of at least one birth. Mild post-transplant narrowing of the vaginal-neovaginal anastomosis was expected; however, the first severe vaginal stricture revealed soon after transplantation was an unpleasant surprise. To prevent post-transplant vaginal stricture, gynecologic surgeons should evaluate the shape and size of the donor's cervix, compare it with the size of the recipient's neovagina and vaginal vault, and perform a vaginal-neovaginal anastomosis to ensure free access for post-transplant cervical biopsies to reveal signs of subclinical rejection and smooth insertion of the embryo transfer catheter into the uterine cavity.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"89 6","pages":"493-495"},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cesarean section incision along the posterior uterine wall - an obstetric and surgical complication of an obstructed pelvis due to previous endometriosis.","authors":"Paolo Meloni, Lucia Penna, Erica Pacella, Terenzia Simari, Roberta Lai, Virginia Bongiovi, Roberto Conturso, Edward Araujo Júnior, Gabriele Tonni","doi":"10.48095/cccg2024304","DOIUrl":"10.48095/cccg2024304","url":null,"abstract":"<p><p>Pelvic endometriosis is a well-known clinical risk factor for pelvic inflammation and adhesions. We present a complex case of a woman undergoing a cesarean section where the traditional incision on the anterior lower uterine segment was not possible due to a congested pelvis. The newborn was delivered using a posterior uterine wall incision with rotation of the round ligament.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"89 4","pages":"304-308"},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful pregnancy in a conserved uterus following hemi-hysterectomy in a case of uterus didelphys","authors":"Markéta Hornová, Zdeněk Žižka, Jan Přáda, Michael Fanta","doi":"10.48095/cccg2024391","DOIUrl":"https://doi.org/10.48095/cccg2024391","url":null,"abstract":"<p><p>We present a rare case report of a patient with a congenital uterine anomaly - uterus didelphys. Who spontaneously became pregnant and completed the pregnancy successfully after peripartum hysterectomy of one uterus. The reason for the peripartum hysterectomy was a life-threatening hemorrhage with hemoperitoneum after cesarean delivery.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"89 5","pages":"391-395"},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrahepatic cholestasis of pregnancy.","authors":"Luděk Kostka, Lukáš Hruban, Petra Morávková","doi":"10.48095/cccg2024405","DOIUrl":"https://doi.org/10.48095/cccg2024405","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this work is to summarize current scientific information focusing on the diagnosis, management, and treatment of intrahepatic cholestasis in pregnancy according to available literature.</p><p><strong>Methodology: </strong>Literature sources were searched using the Web of Science, Scopus, and PubMed/Medline databases.</p><p><strong>Conclusion: </strong>For the diagnosis and proper management of intrahepatic cholestasis of pregnancy, the postprandial serum bile acid value of the pregnant woman is crucial. Postprandial testing allows for a higher likelihood of identifying patients with significantly elevated bile acid levels. Bile acid values above 100 µmol/l, especially in the 3rd trimester, are associated with a significant risk of severe complications, particularly intrauterine fetal death. Ursodeoxycholic acid, the first-line treatment, according to available data, does not improve perinatal outcomes and has minimal effect on the sensation of itching in patients. The routine administration of ursodeoxycholic acid in the treatment of intrahepatic cholestasis of pregnancy is controversial.</p>","PeriodicalId":43333,"journal":{"name":"Ceska Gynekologie-Czech Gynaecology","volume":"89 5","pages":"405-410"},"PeriodicalIF":0.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}